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MDC WEST BEND, LLC
NPI 1497294722
Dentist in West Bend, WI

Active since February 20, 2017
1625 W PARADISE DR, WEST BEND, WI 53095(262) 338-2992 Get Directions Write a Review

NPPES record last updated: February 20, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mdc West Bend, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MDC WEST BEND, LLC (NPI 1497294722) is a healthcare organization registered as a dentist in West Bend, Wisconsin and active in the NPI registry since February 2017. The organization lists Bernard Bolka, Member, as its authorized official.

NPPES Registry Identity

NPI1497294722
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameMDC WEST BEND, LLC
Location Address1625 W PARADISE DRWest Bend, WI 53095-7846
Mailing Address7 Sheboygan StFond Du Lac, WI 54935-4281 · (920) 579-3188
Phone(262) 338-2992
Organization SubpartYesParent: Modern Dental Care Holdings, Llc
Authorized OfficialBernard BolkaMember · (920) 579-3188
Enumeration DateFebruary 20, 2017
✔ NPI 1497294722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in WI · 5479015
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1625 W PARADISE DR, West Bend, WI 53095
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHRISTOPHER FLOOD DDS
Dentist (General Practice)
1625 W PARADISE DR
WEST BEND, WI 53095
Washington County (262) 338-2992
DR. BRANDON KUSIK DMD
Dentist
1625 W PARADISE DR
WEST BEND, WI 53095
Washington County (262) 338-2992

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mdc West Bend, LLC's NPI number?

The NPI number for Mdc West Bend, LLC is 1497294722. It was assigned to this organization in the NPPES registry on February 20, 2017.

Where is Mdc West Bend, LLC located?

Mdc West Bend, LLC is located at 1625 W Paradise Dr, West Bend, WI 53095. The listed phone number is (262) 338-2992.

What is Mdc West Bend, LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Mdc West Bend, LLC was last updated on February 20, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.